Ebp Case Studies

In 2011, there were approximately 3.3 million readmissions to hospitals, raising healthcare costs and negatively impacting patient health. Two important contributors are discharge planning and education. Many patients do not receive enough of either, and are sent home misinformed about their diagnosis and medications. In order to decrease readmissions, hospitals should utilize interactive patient systems to educate patients while they are in the hospital. This will increase patient knowledge of their diagnosis, as well as make it easier for nurses to go over discharge teachings with the patient. This gives

The team will navigate patients through the program, resources and pulmonary rehabilitation. The registered nurse will meet with the patient prior to discharge to evaluate and refer them to the appropriate services along with the social worker, which may find alternative way to pay for patients medication and other support services that may be offered. The nurse practitioner and the respiratory therapist will see the patient within 48 of hours upon admission into program. The nurse practitioner and respiratory therapist will evaluate the needs at home and enroll the patient in pulmonary rehabilitation, which will be part of the care offered to all patients. Resources for the patient will consist of a 24-hour hotline for patients who may need to seek medical advice prior to going to the emergency room. Patient will be supplied with emergency medications for home use if symptoms begin to appear. A nurse practitioner will be available to advice the patient in intervention with the emergency medications is indicated and advice if treatment may need to be continued in the emergency room. With the protocols in place for medications, the patient will be seen within 12 hours if use of the emergency medications were taken in the home. The nurse practitioner will update the electronic medical chart of the patient to document

File, T. (2017). Treatment of community-acquired pneumonia in adults in the outpatient setting. Retrieved from https://www.uptodate.com/contents/treatment-of-community-acquired-pneumonia-in-adults-in-the-outpatient-setting?source=search_result&search=treating%20community-acquired%20pneumonia%20in%20adults&selectedTitle=2~150#H11

I value your capstone project. I work in long-term acute care with clients who are on the vent with compromised pulmonary and cardiovascular problems, and I agree with you that there is limited evidence- based intervention to guide clinicians who work in acute care. It is imperative that OTs take the leadership role and train nurses and CNAs on the importance of bed mobility and transfers to eradicate problems with decreased functional mobility with bedsores and severe sacral wounds secondary to prolonged bed rest.. In addition, lack of physical activity and prolonged bed rest have significant consequences on musculoskeletal, cardiovascular, respiratory, (Parry & Puthucheary, 2015).

Ventilator Associated Pneumonia (VAP) is the second most common infection that patients develop while in the hospital and the leading cause of death due to hospital acquired infections (Augustyn, 2007). Hospital acquired infections are also known as nosocomial infections. VAP usually happens when patients are on mechanical ventilation (the ventilator) for over 48 hours. VAP is costly because it increases the hospital length of stay, often times in the Intensive Care Units (ICU). Patients are often on the ventilator and are receiving antibiotics to treat the pneumonia. This paper will show that

First then RN should evaluate the current needs of the patient by assessing them to see which outcomes have been met and re-advise or update the ones that have not been meet. With-in 24 hours of starting the treatment for pneumonia the patient has had some improvements which suggest at this time the treatment is working.

From investigation in health practices, ventilator associated pneumonia caught my attention. “Ventilator Associated Pneumonia (VAP) is a leading cause of morbidity and mortality in intensive care units. Most episodes of VAP are thought to develop from the aspiration of oropharyngeal secretions containing potentially pathogenic organisms. Aspiration of gastric secretions may also contribute, though likely a lesser degree. Tracheal intubation interrupts the body’s anatomic and physiologic defenses against aspiration, making mechanical ventilation a major risk for Ventilator Associated Pneumonia. Semi-recumbent positioning of mechanically ventilated patients may help reduce the incidence of gastroesophageal reflux and lead to a decreased incidence of VAP. The one randomized trial to date of semi- recumbent positioning shows it to be an effective method of reducing VAP. Immobility in critically ill patients leads to atelectasis and decreased clearance of bronchopulmonary secretions. The accumulation of contaminated oropharyngeal secretions above the endotracheal tube cuff may contribute to the risk of aspiration. Removing these

Ventilator-associated pneumonia (VAP) remains a big drawback within the hospital setting, with terribly high morbidity, mortality, and cost. Some people tend to perform an evidence-based review of the literature that specializes in clinically relevant pharmacological and non-pharmacological interventions to prevent VAP. Thanks to the importance of this condition the implementation of preventive measures is predominant within the care of mechanically ventilated patients. There is proof that these measures decrease the incidence of VAP and improve outcomes within the intensive care unit. A multidisciplinary approach, continuing

Further to this findings, the method was assessed in two lung cancer services and two intensive care units in England. The usage of national trigger records meant that the project took half the time of a normal experience based codesign (EBCD) project and at only 40% of the cost; the records can be used across National Health Service (NHS) settings. Developments that staff and patients recognised and applied together contain reformed lighting systems, suitable clocks to aid patient orientation, tablet computer applications to assist expressed patients communicate, reform of discharge summaries and a new procedure for operational transfer of patient’ possessions from theatre to recovery

Hospitals across the United States are spending copious amounts of resources on research that focuses on providing quality care that not only shortens hospital stays, but also promotes a return to individual functional status prior to admission. Mechanically ventilated patients who remain on bed rest for extended periods of time are at risk of developing complications that can affect all body systems. This literature review examines critically ill patients on mechanical ventilation admitted to the intensive care unit (ICU) and the effects of early mobilization compared to standard bed rest and physical therapy. The findings of this study indicate that early mobilization interventions have been proven to decrease the length of hospital stay, maintain neurological aptitude, and increase muscle function among mechanically ventilated patients experiencing prolonged bed rest.

As a biller and coder we have a responsibility to accurately bill patients for services that were performed. While posting EOBs sometimes mistakes can happen such as the wrong procedures being entered, for example a patient can come into the office for blood in the their urine and sample was sent out for a urinalysis but the patient ended being billed for a urinary tract infection. This may cause the patient to be over or under billed depending on what the insurance covered for these procedures. Another issue that can come up is the biller miscalculating the patients coinsurance resulting again in either under or overpayment.

Attitudes of Respiratory Therapists and Nurses About Measures to Prevent Ventilator-Associated Pneumonia: A Multicenter, Cross-Sectional Survey Study

Jake fidgeted with the play food in front of him. It was obvious he felt comfortable with the other teacher already seated with him; they had a familiarity that came with having known each other for some time. The other four year olds played around him but were careful to avoid his table; possibly from having history with him, or possibly because there was obvious fire in his eyes. A girl walked over and attempted to grab a piece of play food that had been forgotten at the edge of the table. Anger flashed over Jake’s eyes, I could visibly see him controlling his breathing, counting to ten. The moment passed without more incident, but he was careful to collect the food in a tighter pile near him.

Because of relative immaturity of their immune system premature and low birth weight babies are more likely to acquire ESBL K. pneumonia (and other ESBLs). In addition, they are likely to be subjected to different interventional procedures which make them susceptible for infection53.

In addition, tracheostomy placement incidence was decreased to have of what it was within the control group. As the research sought to implement, the day of first mobilization was also significantly changed. Other than these two findings, other outcome changes were not remarkable. The unchanged findings included length of stay, EVD device days, placement of a ventriculoperitoneal shunt days, restraint days, urinary catheter days, and restraint days. As demonstrated by the study, early mobility is not only safe, it is feasible for both the patient and health care team. The patient can only benefit from the implementation of these measures during the hospitalization.